	Valve Quotations Questionnaire

	Pneumatic Actuators Quotations Questionnaire

	Electric Actuators Quotations Questionnaire

Pneumatic Actuators Quotations Questionnaire

Please complete the form in its entirety and click SUBMIT. It will be directed to our Customer Service department.

Contact Information

Date:
Date Required:
Contact:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
End User (or ID No.):
Is this quote for project:		estimate or purchase?
If a purchase, when will purchase be made?
Who is your DynaQuip Controls distributor?

Pneumatic Actuators Information

1. Air supply pressure to be used for sizing? (PSI)

2. Double acting or spring-return?

		Double Acting Spring Return
	If Spring-return, will this valve be expected to "fail" in the open or closed position?
		Fail closed (normal)
		Fail open

3. How frequently will the actuator be required to cycle?

4. How quickly does it need to cycle? (speed)

5. Is corrosion protection required?

Yes No

6. A solenoid pilot valve is required for pneumatic actuators.

7. Is a remote position indicator required?

		Yes No
		Limit Switch Continuous
		Weather-Tight Explosion-Proof
	Is there a preferred actuator mounting orientation? (i.e. parallel or perpendicular to the valve?)

8. Is this an ON/OFF or modulating application?

ON/OFF Modulating

9. Is a Positioner required?

Yes No

Type?